Will Cigna Cover Weight Loss Surgery?
Understanding Cigna's Coverage for Weight Loss Surgery
Cigna does cover weight loss surgery under specific conditions. To qualify for coverage, patients typically need to meet certain medical criteria, including a Body Mass Index (BMI) of 40 or higher, or a BMI of 35 with obesity-related health conditions. Additionally, patients must demonstrate that they have tried other weight loss methods without success. This comprehensive guide will help you understand the requirements and process for getting your weight loss surgery covered by Cigna.
Will Cigna Cover Weight Loss Surgery?
Weight loss surgery, also known as bariatric surgery, can be a life-changing option for those struggling with obesity. Cigna, a prominent health insurance provider, offers coverage for weight loss surgery, but there are specific criteria that must be met. Understanding these requirements is crucial for patients seeking financial assistance for their procedures.
To qualify for coverage, patients generally need to have a Body Mass Index (BMI) of 40 or higher, or a BMI of 35 with associated obesity-related health issues such as diabetes or hypertension. Furthermore, Cigna requires documentation of previous attempts at weight loss through diet, exercise, or medication. This guide will provide detailed insights into Cigna's coverage policies, the types of surgeries covered, and the steps to secure approval.
Types of Weight Loss Surgeries Covered by Cigna
Cigna covers several types of weight loss surgeries, including:
- Gastric Bypass
- Gastric Sleeve
- Adjustable Gastric Banding
- Biliopancreatic Diversion with Duodenal Switch
Quick Facts
Steps to Get Cigna Coverage for Weight Loss Surgery
Step 1: Consult with Your Doctor
Schedule an appointment with your healthcare provider to discuss your weight loss options and determine if you meet the criteria for surgery.
Step 2: Document Previous Attempts
Gather evidence of previous weight loss attempts, including diet plans, exercise routines, and any medications tried.
Step 3: Obtain a Referral
Get a referral to a bariatric surgeon who is in-network with Cigna.
Step 4: Complete Required Evaluations
Undergo psychological and nutritional evaluations as required by Cigna.
Step 5: Submit Pre-Authorization Request
Your surgeon's office will submit a pre-authorization request to Cigna, including all necessary documentation.
Step 6: Await Approval
Wait for Cigna to review your request and provide a decision. This may take several weeks.
Comparison of Cigna's Coverage with Other Insurers
| Insurance Provider | Coverage for Weight Loss Surgery | BMI Requirement |
|---|---|---|
| Cigna | Yes | 40 or 35 with conditions |
| Aetna | Yes | 40 or 35 with conditions |
| UnitedHealthcare | Yes | 40 or 35 with conditions |
Key Takeaways
- Cigna covers weight loss surgery for eligible patients.
- Patients must have a BMI of 40 or higher, or 35 with obesity-related conditions.
- Documentation of previous weight loss attempts is essential.
- Consultation with a healthcare provider is the first step in the process.
- Approval from Cigna may take several weeks after submission of the pre-authorization request.
- Different insurance providers may have similar coverage policies, but always verify specifics.
Jaden Bohman is a researcher led writer and editor focused on productivity, technology, and evidence based workflows. Jaden blends academic rigor with real world testing to deliver clear, actionable advice readers can trust.
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